For Alex, her doctor’s actions had devastating consequences. Shaikha Rahimi spoke with Alex on her harrowing journey to opioid addiction
When Alex first walked into Dr. Smith’s office, she was in pain. She suffered a life-threatening truck accident she didn’t know would forever change the course of her life.
The life she helplessly watched crumble down, prescription after prescription, visit after visit. She was desperate for pain relief, and her doctor of 10-years, Dr. Smith, seemed like a God sent angel.
But behind his clinic’s closed doors, he had a dark secret. A secret that cost Alex her health, family, money, and freedom. A secret that cost Alex her sobriety.
Everything started with a truck accident that deteriorated her spine and left her in chronic pain. When she was admitted to the hospital, she had surgery.
It did not go well. She was given an epidural steroid injection and several IVs.
She felt no difference.
“My pain was so bad I would slam my head between the door and frame. I put my head on the windowsill and would slam the window on my head. I would bang my head on the floor and the steps. All hoping it would numb my pain. That obviously didn’t work and I ended up having spinal fluid drip on my brain,” she says.
Her doctor started her on OxyContin. It is a schedule II-controlled substance and is under legal control of the Drug Enforcement Administration of the U.S Department of Justice.
But Alex’s horror was yet to come.
“By May 2000, I was taking five oxycodone 160mg, 10 oxycodone 80mg, six oxycodone 30mg, eight oxycodone 40mg, and four oxycodone 5mg. That’s 32 tablets every four to six hours. Oh, and antidepressants.
“He was prescribing me 120 oxycodone 8mg, 5mg oxycodone, 60 oxycodone 20mg, and then the big jump, June. I was prescribed 200 oxycodone 80mg, 120 oxycodone 40mg, and then he added Roxicodone 30mg. 200 of them.
To get Alex hooked on the opioids, her doctor wrote the prescriptions for office visit fees.
“He gave me medication on my first visit, and he kept releasing more prescriptions on my return visits without any testing done whatsoever,” she says.
She questioned the frequency of her medications, but Dr. Smith would gaslight her. “I asked him that if the OxyContin is supposed to last 12 hours, why am I taking them every six hours? But he told me this is how I will be ‘able to function and keep busy around the house’.”
Alex’s family were concerned. “My siblings would tell me, ‘Dude, there’s no way the amount of pills you take is normal. People die from that same medication.’
“I spoke to Dr. Smith about my concerns. He told me people who die because of it abuse it by either snorting it or taking it with alcohol. ‘Do you do it that way?,’ he would ask, and I would say ‘no, absolutely not. I follow your directions.’”
But the solution to Alex’s pain was the prescription to America’s downfall.
Dr. Lisa Kugler, a psychologist, healthcare executive, and the Senior Vice President of the ATLAS (Addiction Treatment Locator, Assessment and Standards) platform at Shatterproof Charity, says the opioid crisis started in the United States as a result of pharmaceutical companies aggressively marketing opioid painkillers.
“The opioid crisis started when healthcare providers promoted the concept that pain should be considered as the fifth vital sign, an essential indicator to be assessed and treated along with other vital signs like blood pressure. It was widely embraced and the pharmaceutical industry started marketing painkillers to manage chronic pain more effectively.
“In the late 1990s and early 2000s, the rate of opioid prescriptions and addictions began to snowball, but despite that, addiction is still stigmatised and misunderstood,” says Dr. Kugler.
“One of the keys to reducing overdose fatality is reducing the stigma associated with drug addiction, and it is important we remember that these people are separate from their addiction.
“They are a brother, a sister, a friend. They are a person.
“Organisations like Shatterproof work to combat the opioid crisis and promote evidence-based practices that can help individuals struggling with addiction to access the care and support they need to achieve long-term recovery. The practices we promote are grounded in scientific research and are rigorously tested.
“The general public can work to prevent opioid addiction by increasing awareness about the dangers of opioid use and encouraging people to speak when they need help.
“Drug addiction problems including opioids have been around for years and it has affected communities across the country, but it is important to understand that addiction is like any other chronic condition. There is a chance of relapse,” she says.
Alex, trapped in a spiral of addiction and manipulation, watched her life deteriorate.
But she was addicted. She kept going.
“I was going to his office every six days for refills. That was what my daily dosage consisted of at the peak of my addiction - 200 oxycodone 160mg, 200 oxycodone 80mg, 200 oxycodone 30mg, and then he added 360 methadone tablets every six days. My out-of-pocket payments were, um,” she says while her hands are trembling as she reaches out to begin counting. “I think $5,000.
“I trusted him. He never told me how addictive these pills could be. People told me he was a quack, but I said he was my quack.
Each pill she swallowed was like another drop in an already overflowing bucket. She had to bear the harrowing effects of her addiction and the crushing weight of its financial burden.
“I couldn’t afford the pills, so I reached out to Dr. Smith and told him about the financial burden the medication was putting on me. He told me to do the ‘doctor-type of billing’ with my insurance company. In other words, he was teaching me how to falsify records.
“I was indicted on charges of insurance fraud and I served five months. All I did was walk, write, and listen to music. Most nights I cried myself to sleep.
When Alex was released, she went to Dr. Smith. She was curious to see what the expression on his face would be if she came in for an appointment. “He asked how I’m feeling, but nothing about jail. He told me, ‘If you need to go back onto the OxyContin, I’m here to help. No one can say you can’t take this medication if you need it’.”
Desperate for a way out, Alex reached out to countless rehab centres. “All the responses were that I had no chance of rehab because I was four suicide dosages over what they can do for a supervised detox,” she says. “I was told I had to pay $25,000 in order to get into a detox, and, the hardest part, I needed to come down at least three quarters of what my highest dose was. The highest I was taking daily was 5,200.
Alex’s heart was heavy as she recounted the numerous rehab centres that had turned her away. But just as she was beginning to lose faith, she received a call from a friend.
Startled, Alex picked up the phone to hear her friend on the other end, her words jumbled with excitement and urgency. She struggled to make sense of what she was saying and her heart was racing. The words slowly began to form a coherent sentence. “Did you hear what happened? Dr. Smith was indicted on drug charges.”
A warrant was issued for his arrest. He turned himself in the next day.
The weight of those words hit her like a ton of bricks. For years, Alex had been living in a constant state of misery, plagued by the actions of a doctor she trusted.
When she hung up the phone, her mind began to race with a thousand different thoughts, wondering what that meant for her own future. For now, it didn’t matter.
“He was given a five-year sentence. He lost his medical license and lost his practice. If he has lost anything else, to this day, I am not aware and frankly I kind of don’t care.
His charges were the intent to distribute controlled substances, conspiracy to distribute controlled dangerous substances, and conspiracy to launder any proceeds of unlawful drug transactions. He was charged for prescribing powerful painkillers - oxycodone, Roxicodone, and morphine sulphate - without any legitimate medical purpose.
The opioid crisis looms over the world like a dark cloud casting its shadows across the globe. And now, with fears that it may be spreading like a contagion to new shores, people are starting to feel a sense of unease and anxiety.
The UK, in particular, is being eyed with concern, as many worry that it may be the next destination for this insidious epidemic.
Alex was a victim of Dr. Smith’s long list of crimes. From this point on, it wasn’t long before the withdrawal symptoms began to torment her with unbearable pain. She was rushed to the hospital, her body writhing in agony as the doctors worked to save her life. Even as they fought to keep her alive, she felt herself slipping away.
“I don’t remember anything but waking up days later and seeing pumps and hoses equipped in me,” she says. “I had a massive heart attack.”
Alex’s body was frail and hooked up to a tangle of tubes that kept her alive. The doctors had given up hope, telling her family and friends to prepare for the worst.
“But I’m here. Once again, my angel was by my side.”
“When I reflect on my journey, I am reminded of all the sacrifices and losses. I lost time, hard-earned money, my husband and family. But the one thing I have today is my sobriety and I’m alive to tell my story.
“Today, I am grateful to be alive and share my journey with those who might be struggling with similar challenges.”
And as she looks towards the future, she knows she has a purpose - to share her story, to offer hope and inspiration to those who might be lost in the darkness. She is a survivor, a fighter, and a shining example of what it means to never give up.
If you or someone you know is struggling with substance misuse, know that you are not alone. There is hope, and recovery is possible. Seek help today from organisations like WeAreWithYou for support and resources to help on the path to recovery.
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